Prisoners’ perspectives on health: Insights from a Norwegian low-security prison

Abstract Prisons are important settings for health promotion, involving individual efforts and broader environmental and policy measures. However, they present challenges due to structural constraints, such as limited agency and health-related choices, compounded by prisoners’ marginalized status. Understanding how prisoners perceive health is key, as lay perspectives on health can enhance policy relevance and challenge expert knowledge, fostering a more holistic approach to health promotion. This study examines prisoners’ health perspectives within a low-security prison. Set in ‘Forest Prison’, a low-security facility in Norway with a capacity of 115 male prisoners, this study explores health perspectives in a less restrictive environment compared to high-security prisons, while still capturing the impact of incarceration. 20 semi-structured individual interviews with prisoners of various ages, social backgrounds, and ethnicities were transcribed and analysed using thematic analysis. The findings reveal that while prisoners share health perspectives with the general population - such as health as the absence of illness, functionality, social relationships, and psychosocial well-being - the prison environment introduces unique elements. Life in prison shapes health perspectives, with restrictive conditions adding strain and stress, and limiting choices, which become integral to their prison-specific health understanding. Aspects including incarceration-related harm, trust issues, and fear of sanctions, are included in prisoners’ health perspectives. Concerns about the future, particularly reintegration and life after release, also emerge as significant elements of prisoners’ understanding of health. Recognizing prisoners’ health perspectives is crucial for developing holistic health-promoting measures relevant to them, addressing both general and prison-specific health aspects. The findings offer insights that may be applicable to other prisons in Norway and internationally. Key messages • Understanding prisoners’ lay perspectives on health can improve the relevance of health promotion policies and challenge expert knowledge, fostering a more holistic approach. • While prisoners share health perspectives with the general population, the prison environment shapes unique health perspectives.